Skip to main content Accessibility help

Evaluating the Impact of Pharmacies on Pandemic Influenza Vaccine Administration

  • Joy Schwerzmann (a1), Samuel B. Graitcer (a2), Barbara Jester (a1), David Krahl (a3), Daniel Jernigan (a4), Carolyn B. Bridges (a2) and Joseph Miller (a5)...



The objective of this study was to quantify the potential retail pharmacy vaccine administration capacity and its possible impact on pandemic influenza vaccine uptake.


We developed a discrete event simulation model by use of ExtendSim software (Imagine That Inc, San Jose, CA) to forecast the potential effect of retail pharmacy vaccine administration on total weekly vaccine administration and the time needed to reach 80% vaccination coverage with a single dose of vaccine per person.


Results showed that weekly national vaccine administration capacity increased to 25 million doses per week when retail pharmacist vaccination capacity was included in the model. In addition, the time to achieve 80% vaccination coverage nationally was reduced by 7 weeks, assuming high public demand for vaccination. The results for individual states varied considerably, but in 48 states the inclusion of pharmacies improved time to 80% coverage.


Pharmacists can increase the numbers of pandemic influenza vaccine doses administered and reduce the time to achieve 80% single-dose coverage. These results support efforts to ensure pharmacist vaccinators are integrated into pandemic vaccine response planning. (Disaster Med Public Health Preparedness. 2017;11:587–593)


Corresponding author

Correspondence and reprint requests to Joseph Miller, Mail Stop C-17, Division of Scientific Resources/National Center for Emerging and Zoonotic Infectious Diseases, 1600 Clifton Road, Atlanta, GA 30333 (e-mail:


Hide All
1. Comments from the Center for Biosecurity of UPMC on the National Strategy for Pandemic Influenza: implementation Plan. Biosecur Bioterror. 2006;4(3):320-324.
2. Grohskopf, LA, Sokolow, LZ, Olsen, SJ, et al. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices, United States, 2015-16 Influenza Season. MMWR Morb Mortal Wkly Rep. 2015;64(30):818-825.
3. Flu Vaccination Coverage, United States, 2015-2016 Influenza Season. Centers for Disease Control and Prevention website. Accessed January 11, 2017.
4. Appiah, GD, Blanton, L, D’Mello, T, et al. Influenza activity — United States, 2014-15 season and composition of the 2015-16 influenza vaccine. MMWR Morb Mortal Wkly Rep. 2015;64:583-590.
5. Estimated Influenza Illnesses and Hospitalizations Averted by Vaccination — United States, 2014–2015 Influenza Season. Centers for Disease Control and Prevention website. Accessed November 29, 2016.
6. Lu, PJ, O’Halloran, A, Ding, H, et al. National and state-specific estimates of place of influenza vaccination among adult populations - United States, 2011-12 influenza season. Vaccine. 2014;32(26):3198-3204.
7. National Early Season Flu Vaccination coverage, United States, November 2015. Centers for Disease Control and Prevention website. Accessed January 11, 2017.
8. Vaccines for Children Program (VFC). Centers for Disease Control and Prevention website. Accessed January 11, 2017.
9. Goad JA. Pharmacist Challenges in Providing Immunizations. NFID News website. Published May 15, 2015. Accessed January 11, 2017.
10. Howden, LM, Meyer, JA. Age and sex composition: 2010. 2010 Census Briefs. 2010;2011:1-15. Accessed January 11, 2017.
11. Davila-Payan, C, Swann, J, Wortley, PM. System factors to explain 2009 pandemic H1N1 state vaccination rates for children and high-risk adults in US emergency response to pandemic. Vaccine. 2014;32(2):246-251.
12. Krahn, M, Guasparini, R, Sherman, M, et al. Costs and cost-effectiveness of a universal, school-based hepatitis B vaccination program. Am J Public Health. 1998;88(11):1638-1644.
13. Schmier, J, Li, S, King, JC, et al. Benefits and costs of immunizing children against influenza at school: an economic analysis based on a large-cluster controlled clinical trial. Health Aff (Millwood). 2008;27(2):w96-w104.
14. Szilagyi, PG, Iwane, MK, Schaffer, S, et al. Potential burden of universal influenza vaccination of young children on visits to primary care practices. Pediatrics. 2003;112(4):821-828.
15. Mercer, NJ. Cost analysis of public health influenza vaccine clinics in Ontario. Can J Public Health. 2009;100:340-343.
16. Caum, J, Alles, S. Ready or not: analysis of a no-notice mass vaccination field response in Philadelphia. Biosecur Bioterror. 2013;11(4):262-270.
17. Szilagyi, PG, Iwane, MK, Humiston, SE, et al. Time spent by primary care practices on pediatric influenza vaccination visits: implications for universal influenza vaccination. Arch Pediatr Adolesc Med. 2003;157(2):191-195.
18. Washington, ML, Humiston, SG, Fauerbach, PB, et al. A personnel time-motion study of intranasal influenza vaccination in healthy children. Vaccine. 2005;23(40):4879-4885.
19. Hogue, MD, Grabenstein, JD, Foster, SL, et al. Pharmacist involvement with immunizations: a decade of professional advancement. J Am Pharm Assoc. 2006;46(2):168-182.
20. Westrick, SC, Watcharadamrongkun, S, Mount, JK, et al. Community pharmacy involvement in vaccine distribution and administration. Vaccine. 2009;27(21):2858-2863.
21. Rosenfeld, LA, Etkind, P, Grasso, A, et al. Extending the reach: local health department collaboration with community pharmacies in Palm Beach County, Florida for H1N1 influenza pandemic response. J Public Health Manag Pract. 2011;17(5):439-448.
22. Murphy, PA, Frazee, SG, Cantlin, JP, et al. Pharmacy provision of influenza vaccinations in medically underserved communities. J Am Pharm Assoc. 2012;52(1):67-70.
23. Goad, JA, Taitel, MS, Fensterheim, LE, et al. Vaccinations administered during off-clinic hours at a national community pharmacy: implications for increasing patient access and convenience. Ann Fam Med. 2013;11(5):429-436.
24. Deshpande, M, Schauer, J, Mott, DA, et al. Parents’ perceptions of pharmacists as providers of influenza vaccine to children. J Am Pharm Assoc. 2013;53(5):488-495.
25. Ndiaye, SM, Madhavan, S, Washington, ML, et al. The use of pharmacy immunization services in rural communities. Public Health. 2003;117(2):88-97.
26. Gallup. Honesty/Ethics in Professions. Vol 2014.
27. Miller, S, Patel, N, Vadala, T, et al. Defining the pharmacist role in the pandemic outbreak of novel H1N1 influenza. J Am Pharm Assoc. 2012;52(6):763-767.
28. Hurley, LP, Wortley, P, Allison, MA, et al. Seasonal influenza vaccination in adults: practice and attitudes about collaborative delivery with community vaccinators. Vaccine. 2011;29(47):8649-8655.
29. Hurley, LP, Bridges, CB, Harpaz, R, et al. U.S. physicians’ perspective of adult vaccine delivery. Ann Intern Med. 2014;160(3):161-170.
30. Rothholz, MC; American Pharmacists Association, Academy of Managed Care Pharmacy. Pharmacist-provided immunization compensation and recognition: white paper summarizing APhA/AMCP stakeholder meeting. J Am Pharm Assoc. 2011;51(6):704-712.
31. Fitzgerald, TJ, Kang, Y, Bridges, CB, et al. Integrating pharmacies into public health program planning for pandemic influenza vaccine response. Vaccine. 2016;34(46):5643-5648.
32. Klepser, ME. Seasonal and pandemic influenza: preparing pharmacists for the frontline. J Am Pharm Assoc. 2008;48(2):312-314.
33. Resources and Tools to Improve Collaboration Between Public Health and Pharmacies to Prepare for and Respond to a Pandemic. Pandemic Influenza page. Association of State and Territorial Health Officials website. Accessed November 29, 2016.
34. Pharmacy and Public Health Collaboration. American Pharmacists Association website. Accessed November 29, 2016.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Disaster Medicine and Public Health Preparedness
  • ISSN: 1935-7893
  • EISSN: 1938-744X
  • URL: /core/journals/disaster-medicine-and-public-health-preparedness
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed